Invasive Dental Treatment Research Articles

Risk factors for dental findings of the development of medication-related osteonecrosis of the jaw: Investigation of 3734 teeth in cancer patients receiving high dose antiresorptive agents

Background/purposeLocal infection is a risk factor for medication-related osteonecrosis of the jaw (MRONJ), along with invasive dental treatment of the bone; the tooth that is the source of infection should be extracted prior to the administration of bone resorption inhibitors. However, which teeth should be extracted remains unclear. This study aimed to determine the relationship between dental findings prior to high-dose antiresorptive agent (ARA) administration and the subsequent development of MRONJ. Materials and methodsPatients with cancer who were scheduled to receive high-dose ARAs and referred to our hospital between 2011 and 2020 were included in this retrospective study. Apical lesions, enlargement of the periodontal space, thickening of the lamina dura, alveolar bone resorption of >1/3, periapical osteosclerosis, and local infection symptoms in each tooth were investigated using medical records and panoramic radiographs. ResultsA total of 172 patients, 329 jaws, and 3734 teeth were registered. MRONJ developed in 68 teeth in 33 jaws of 32 patients. In tooth-by-tooth analysis, fewer teeth (P < 0.001), apical lesions (P < 0.001), periapical osteosclerosis (P < 0.001), local infection symptoms (P = 0.002), and one or more dental findings (P < 0.001) were significant factors for MRONJ development. In jaw-by-jaw analysis, old age, local infection symptoms, and number of radiographic abnormalities per tooth were significant. In patient-by-patient analysis, patients with diabetes and those with fewer teeth developed MRONJ. ConclusionPatients with fewer teeth, apical lesions, periapical osteosclerosis, and local infection were more likely to develop MRONJ. Therefore, these teeth should be treated as much as possible before ARA administration.

Impact of Dental Treatment on Oral Health-Related Quality of Life of Patients.

It is crucial to understand how individuals perceive the impact of oral disorders and the treatment associated with or received for those disorders on their quality of life. A relatively new but quickly spreading concept of oral health-related quality of life (OHRQoL) that notably affects three fields, clinical dental practice, dental research, and dental education makes it feasible to figure out the relationship between oral health and its impact on the quality of life of an individual. OHRQoL can be measured in various ways; the most well-liked method uses a multiple-item questionnaire. There haven't been any prior attempts to compare the effects of various invasive and non-invasive dental therapies on OHRQoL, even though few studies have been conducted to evaluate the OHRQoL among patients undergoing independent dental procedures. Such a comparison would aid in our understanding of not only how various dental conditions affect OHRQoL, but also whether or not a patient's OHRQoL has improved as a result of various therapies for these diseases. A longitudinal study was conducted on patients receiving invasive and non-invasive dental treatment at Teerthanker Mahaveer Dental College and Research Centre, Moradabad. A two-part questionnaire, the first part of which consists of questions related to the demographic details of the patient and the second part consisting of a set of 14 questions of the oral health impact profile (OHIP)-14 for assessing the OHRQoL, was used in the study. Patients' baseline OHRQoL was assessed before the commencement of any treatment by the interview method and follow-up OHRQoL was assessed three days, sevendays, one month, and six months post-treatment telephonically. The OHIP-14 contains 14 items on the frequency of adverse impacts caused by oral conditions and the patients were asked to rate each item on a 5-point Likert scale as 0=never; 1=hardly ever; 2=occasionally; 3=fairly often; 4=very often. The results obtained after compiling and analyzing the data from a total sample of 400 indicate that the mean difference in the OHIP score at different time intervals between the groups who undertook invasive and non-invasive treatment was significant as the p-value was less than 0.05. In addition, it was observed that the mean difference at baseline was statistically significant in the invasive and non-invasive groups as the p-value is less than 0.05. At the domain level, the mean score at each domain was higher in the invasive group as compared to the non-invasive treatment group after three days and seven days of treatment. The mean difference between the group treated with invasive treatment on day three and the group treated with non-invasive treatment on day seven was statistically significant as the p-value is less than 0.05. The mean score was high in the invasive group as compared to the non-invasive group after one month and six months of treatment. The present study was conducted to assess dental treatment's impact on oral health-related quality of life in patients attending Teerthanker Mahaveer Dental College and Research Centre, Moradabad. Results from this study indicated that both types of treatments either invasive or non-invasive have significantly influenced the OHRQoL. Post-treatment OHRQoL improved at different intervals after receiving either treatment.

Incorporating cancer survivorship care in dental education.

Incorporating cancer survivorship care in dental education.

Preoperative HbA1c and Blood Glucose Measurements in Diabetes Mellitus before Oral Surgery and Implantology Treatments

Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental associations. Furthermore, to gather evidence on the uni/bidirectional relationships of elevated HbA1c levels on dental surgery, implantology, bone augmentation, and periodontology and to demonstrate the importance of measuring HbA1c levels before invasive dental treatments. HbA1c and blood glucose measurements are a minimally invasive method for preventing complications in diabetes mellitus. The authors conducted a literature review to determine which oral conditions are affected by diabetes mellitus. MEDLINE served as a source with the use of a specific search key. Regarding oral complications of diabetes, prevention is the most vital factor. With this publication, we hope to assist physicians and dentists to make prompt diagnoses and to help in recognizing various oral manifestations of diabetes and follow the existing guidelines.

Robotics in Dentistry: A Narrative Review.

Robotics is progressing rapidly. The aim of this study was to provide a comprehensive overview of the basic and applied research status of robotics in dentistry and discusses its development and application prospects in several major professional fields of dentistry. A literature search was conducted on databases: MEDLINE, IEEE and Cochrane Library, using MeSH terms: ["robotics" and "dentistry"]. Forty-nine articles were eventually selected according to certain inclusion criteria. There were 12 studies on prosthodontics, reaching 24%; 11 studies were on dental implantology, accounting for 23%. Scholars from China published the most articles, followed by Japan and the United States. The number of articles published between 2011 and 2015 was the largest. With the advancement of science and technology, the applications of robots in dental medicine has promoted the development of intelligent, precise, and minimally invasive dental treatments. Currently, robots are used in basic and applied research in various specialized fields of dentistry. Automatic tooth-crown-preparation robots, tooth-arrangement robots, drilling robots, and orthodontic archwire-bending robots that meet clinical requirements have been developed. We believe that in the near future, robots will change the existing dental treatment model and guide new directions for further development.

Are childhood oral health behaviours and experiences associated with dental anxiety in adolescence?

Dental anxiety is associated with untreated dental caries. Understanding which childhood behaviours or experiences have the strongest association with later dental anxiety may help focus preventive strategies, subsequently limiting the burden of dental caries and anxiety. The aim of this study was to explore whether behaviours and experiences during childhood were associated with adolescent dental anxiety. Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable logistic regression was used to explore associations between adolescent dental anxiety and childhood behaviours and experiences. 1791 participants answered questions about oral health behaviours and experiences at 8 years of age and dental anxiety questions aged 17 years. Children with experience of invasive dental treatment were more likely to have dental anxiety at 17 years of age than those who had not experienced dental treatment (OR 1.63; 95% CI: 1.12, 2.37; p=.011). Irregular dental attenders in childhood had over three times the odds of dental anxiety by adolescence, compared with regular attenders (OR 3.67 95% CI: 1.52, 8.88; p=.004). Adolescent dental anxiety is associated with invasive treatment and irregular dental attendance in childhood. A history of irregular attendance or invasive treatment may serve as a useful predictor when considering dental anxiety in young adult patients. Early preventive care supports good attendance and oral health. These actions may have secondary effects of reducing future dental anxiety.

Anxiety level and physiological response to invasive dental treatments. a longitudinal study

To determine the relationship between the level of anxiety and the physiological response to invasive dental treatments. A convenience sample of 180 patients was formed (73 men and 107 women) ≥18 years (range: 18-58) undergoing treatment with local anesthetics from three private dental offices in the city of Lima. Measurements were made before, during and after treatment on anxiety according to the IDARE questionnaire of 40 questions (20 trait and 20 state) and their physiological response was evaluated according to oxygen saturation (OS), pulse and blood pressure (BP) measured. with digital pulse oximeter and blood pressure monitor. The Friedman and Spearman correlation tests were used, working with a value of P<0.05. Most patients had a medium level of anxiety before dental treatment (state 49.4% and trait 55.6%). OS, pulse and BP increased after application of the anesthetic and decreased at the end of treatment, with significant differences (P<0.05). Anxiety scores were significantly correlated only with pulse (state: r=0.238-0.564; trait: r=0.174-0.323) and BP (state: r=0.429-0.699; trait: r=0.312-0.465) (P<0.05). State-trait anxiety had a positive relationship with the physiological dimensions of blood pressure and pulse before dental treatment with local anesthetics.

Nociception associated with pain/distress in young children sedated for dental treatment: a clinical study with objective and subjective measures.

To evaluate the association between children's pain/distress levels and patient characteristics (age, sex, history of dental pain), sedation type (level of sedation, sedative regimen), nociception and pain intensity reported by the parents in sedated children undergoing minimally invasive dental treatment. This clinical study evaluated secondary outcomes of an RCT that evaluated the efficacy of dexmedetomidine sedation with or without ketamine. Only children who had nociception levels recorded using the Analgesia Nociception Index (ANI) were included (0-100; 0 = highest nociception). FLACC scale (Face, Legs, Activity, Cry and Consolability) was used to assess children's pain/distress (0-10; 0 = no pain/distress). Parental proxy report of the child's pain intensity during the treatment was performed using the Visual Analogue Scale (VAS; 0-100; 0 = no pain). The association between ANI, children's age and sex, dental pain history, sedation level, sedative regimen, and VAS with the FLACC was verified using the generalised estimation equation analysis (alpha 0.05). Participants were 31 children (51.6% boys) and their parents (90.3% mothers). Median FLACC was 3.3 (25th-75th percentiles 1.7-8.2), ANI 80.9 (74.7-85.8), and VAS 10 (1-23). FLACC associated with ANI (OR 0.96; 95% CI 0.93-0.99; p = 0.02), moderate sedation (0.13; 0.03-0.50; p = 0.003), and VAS (1.05; 1.01-1.10; p = 0.01). Pain/distress was generally low and more prominent with minimal (versus moderate) sedation and higher nociception.

Effect of the Case for Carpule as a Visual Passive Distraction Tool on Dental Fear and Anxiety: A Pilot Study.

The present cross-over study aimed to evaluate the effect of a visual passive distraction tool, a case for carpule, in the management of fear and anxiety during invasive dental treatment. Children between the ages of 4 and 8 years that need at least two treatments with inferior alveolar nerve block were selected. All the included children received two treatments at different moments: in one treatment, local anesthesia was performed with a visual passive distraction tool, the crocodile case, for carpule (experimental); in the other treatment, local anesthesia was performed without the device (control). An evaluation of the anxiety levels was performed by measuring the heart rate and salivary cortisol levels. Wilcoxon's nonparametric test was used for a data analysis (p < 0.05). The mean heart rate with the visual passive distraction device fell from 81.8 to 78.1, while the control rose from 91.4 to 100 (p < 0.05). The mean salivary cortisol levels with the visual passive distraction device fell from 2.0 to 1.6, while in the control, they rose from 2.1 to 2.4 (p < 0.05). In conclusion, the crocodile case for carpule as a visual passive distraction device contributed positively to the management of fear and anxiety during inferior alveolar nerve block in children.

Dental Caries and Its Management.

In recent years, the management of dental caries has evolved significantly. Caries prevention, early detection, and a diagnosis based on risk indicators and risk factor assessments are the most current practical approaches. Furthermore, as proposed in minimally invasive dentistry, the new management approaches preserve healthy tissue and maintain pulp vitality. This article overviews the latest minimally invasive dental caries management and treatment options. The information will assist the reader in the early detection, diagnosis, and treatment of dental caries. The PubMed (MEDLINE) search engine was used to gather the most relevant information on dental caries. The search was restricted to five years (May 30, 2018-May 29, 2022), and only English-language studies were accessed. A Boolean search of the PubMed data set was implemented to combine a range of keywords. The following filters were applied: abstract, free full text, full text, clinical trial, randomised control trial, systematic review, meta-analysis, and review. More studies were also obtained by manual searches from Google Scholar and textbooks on dental caries. By using this process, 683 articles and studies were obtained. The most relevant published studies were chosen and used in the current review. The selected articles are included in the references list. However, the search extended to cover the last five years as our understanding and management of dental caries have changed significantly. Early detection and diagnosis of caries based on risk indicators and risk factor assessments are effective. Furthermore, minimally invasive restorative techniques are beneficial in managing dental caries and preserving healthy tissue and should be used whenever possible. This new information, knowledge, and materials should encourage professionals to implement this method. Having a strategy and system based on patient-centred care is critical, and our dental responsibilities must prioritise patient-centred care.

Prevalence of Anxiety amongst Interns while Performing Treatments in Dental Colleges of Navi Mumbai: A Cross-sectional Survey

Introduction: Anxiety is one of the most commonly experienced disorders across gender and all ages. Dental anxiety seen in patients prior to or during treatment is a well-researched topic. However, anxiety experienced by interns while treating patients in the dental college is a lesser explored side of the same coin. Aim: To evaluate and understand the prevalence of anxiety experienced by dental interns while performing treatments in a college clinical set-up and studies the various factors precipitating anxiety. Materials and Methods: This cross-sectional survey was conducted using Google forms, amongst interns of five dental colleges in Navi Mumbai region from July 2021 to October 2021. A sample size of 350 was derived by convenient sampling method. The parameters assessed via questionnaire through a Likert-type response scale included various factors precipitating anxiety amongst interns such as performing invasive dental treatments, lack of in-depth knowledge of procedures, age, attitude and medical conditions of patients, encountering complications while treating patients, presence of supervision and working with anxious peers. Chi-square test was performed to analyse collected data, extract results and draw a conclusion. Results: Out of 350 participants, 332 showed symptoms of anxiety while treating patients in clinics. No significant gender predilection was noted for anxiety (p=0.544). Factors precipitating anxiety included performing invasive dental treatments (p=0.0004), lack of in-depth knowledge of certain procedures (p=0.020), patient’s attitude (p=0.017), treating patients with certain medical conditions (p=0.035) as well as encountering complications while treating patients (p=0.022). A significant number of participants thought that anxiety leads to more procedural errors (p=0.010). The need to incorporate anxiety management in the dental curriculum was observed (p=0.023). Conclusion: The results of this study showed prevalence of anxiety amongst dental students and highlighted the need to incorporate anxiety management programs in the curriculum. Preparing interns to cope with anxiety resulting from treating patients seems to be of importance for their future clinical practice.

Evaluation of Intraligamentous and Intraosseous Computer-Controlled Anesthetic Delivery Systems in Pediatric Dentistry: A Randomized Controlled Trial.

Computer-controlled local anesthetic delivery systems (CDS) represent one of the resources that have progressed the most in recent years, but their efficacy and applicability in pediatric dentistry is still the subject of certain controversies. This randomized, controlled, split-mouth clinical trial assessed two CDS in children (n = 100) with deep caries in the temporary dentition that required invasive therapeutic procedures, using inferior alveolar nerve block as the gold standard. Half of the patients (n = 50) underwent the intraligamentary technique (Wand STA®) on one side of the mouth and conventional inferior alveolar nerve block on the contralateral side, while the other half (n = 50) underwent the intraosseous technique (QuickSleeper®) on one side of the mouth and conventional inferior alveolar nerve block on the contralateral side. The following were considered covariates: age, sex, type of dental procedure and the applied local anesthesia system. The outcome variables were the pain caused by the anesthesia injection, the physical reaction during the anesthesia injection, the need for anesthetic reinforcement, pain during the therapeutic procedure, the overall behavior during the visit, the postoperative morbidity and, lastly, the patient's preference. In conclusion, we confirmed the efficacy of intraligamentary and intraosseous techniques administered using a CDS for conducting invasive dental treatments in children, their advantages compared with inferior alveolar nerve block in terms of less pain generated by the anesthesia injection and less postoperative morbidity, as well as the pediatric patients' preference for CDS versus conventional techniques.

Predictors of Dental Fear and Anxiety in 9-12-year-old Children in Bosnia and Herzegovina.

Oral health in children is additionally burdened with the presence of dental fear and anxiety (DFA). These clinical psychologic entities in their progressive stages inevitably lead to avoidance of dental appointments, which makes prevention and therapy of oral diseases more difficult. Upon the onset of DFA in general, as one of the emotional outcomes of stress in a dental office, most children patients could define the specific stressors that were most intense for them, which could predict the presence of DFA. To examine the predictors of DFA presence in 9-12-year-old children, and investigate how they could explain the DFA occurrence in study participants. The sample consisted of 200 children aged from 9 to 12 years. The DFA presence was determined by the modified version of the CFSS-DS scale. The child's behavior in the dental office during the treatment was evaluated by the trained observer using Venham anxiety and behavior rating scales. Socioeconomic status, characteristics of dental office visits, and previous caries experience were also analyzed. The main DFA predictors were related to invasive dental treatments, where the behavior during dental treatment was the most accurate expression of the DFA appearance. Invasive dental procedures are the main stressful factor for DFA occurrence. Predisposing factors could strengthen the DFA occurrence.

The risk of endocarditis in hemodialysis patients who have undergone invasive dental treatment: a cohort case-control analysis of the Taiwan National Health Insurance Database.

The objective of this study was to determine if hemodialysis patients who have undergone an invasive dental treatment are at risk of developing infective endocarditis. This study was a cohort case-control design and used secondary data collected from the National Health Insurance Research Database of Taiwan. The case group and the control group were each comprised of 19,602 hemodialysis patients. The control group was matched for four variables: age, gender, a medical history of diabetes mellitus, and a cerebrovascular event. After matching, the case group and the control group were each comprised of 19,602 hemodialysis patients. Cox regression analysis determined hazard ratios and 95% confidence intervals. Patients were followed up at 1month and 3months after receiving invasive dental treatment. The results showed the cohort case-control hazard ratio was 0.88 (95% CI, 0.49, 1.57) 1month after receiving invasive dental treatment. Three months after receiving IDT, the cohort case-control hazard ratio was 1.04 (95% CI, 0.71, 1.52). Hazard ratios did not differ significantly between groups. Hemodialysis patients who received invasive dental treatment had no greater risk of developing infective endocarditis than matched control patients. The results of this study should alleviate concerns for hemodialysis patients and dentists about invasive dental treatment procedures. We recommend hemodialysis patients undergo invasive dental treatment when needed. The results of this study showed that invasive dental treatment did not increase their risk of developing infective endocarditis. Hemodialysis patients in need of an invasive dental procedure should be encouraged to undergo treatment if the dentist deems it necessary.

The effect of image processing filters in detection of apical root resorption, interproximal dental decay, and vertical root fractures: A review

<h3>Background</h3> Digital radiography has been available in dentistry for over 35 years and its usage by dental practitioners is now a prerequisite for providing the standard of care. One advantage of digital radiography is the use of image processing filters (IPFs) to increase the diagnostic signals and decrease the non-diagnostic signals. For various diagnostic purposes, IPFs can be selected based on the practitioner's demand, experience, and decision. <h3>Objectives</h3> The purpose of this study was to evaluate published reports of the effectiveness of image processing filters (IPFs) of digital radiographs in detecting apical root resorption (ARR), interproximal dental decay (IDD), and vertical root fractures (VRF). <h3>Study design</h3> Original research presentations were selected by using the following inclusion criteria: (1) CMOS digital x-ray images, (2) IPFs built in to the MiPACS image management software, (3) Questionnaire studies, and (4) Studies that used human teeth. The search was limited to studies of Loma Linda University School of Dentistry Center for Dental Research. <h3>Results</h3> The search resulted in 3 studies fulfilling the above criteria, which evaluated IPFs in ARR, IDD, and VRF. ICC analysis showed excellent correlation in all studies. For ARR, the most accurate diagnoses as measured with the area under the curve (AUC) of receiver operating characteristic analysis was obtained with the Endo filter (AUC = .950; 95%CI: .869 - 1.0). The least accurate was the Dentin to Enamel filter (AUC = .758; 95%CI: .551 - .965). For IDD, the Edge Enhance filter was most accurate (AUC = 0.772; 95%CI: .669- .875) and the least was the Dentin to Enamel filter (AUC = 0.420; 95%CI: .287 - .553). For VRF, the most accurate diagnoses were achieved with the Contrast filter (AUC = 0.769; 95%CI: .687 - .851); the Endo filter was least accurate (AUC = 0.702; 95%CI: .612 - .792). <h3>Conclusions</h3> IPF can affect the diagnosis of ARR, IDD, and VRF depending on which type of filter is applied. A proper selection of filters is recommended to increase the possibility of the early diagnosis of pathology, thus reducing the need for further invasive dental treatment. <b>Statement of Ethical Review</b> Human/Animal subjects were used and this study was approved by an institutional ethics panel

A 5-year retrospective cohort study of denosumab induced medication related osteonecrosis of the jaw in osteoporosis patients

Denosumab has been suggested as a first-line therapy for osteoporotic patients. However, a standardized protocol for the prevention of denosumab induced medication-related osteonecrosis of the jaw (MRONJ) has not yet been established. The purpose of this study was to report denosumab induced MRONJ cases, and investigate the factors affecting the occurrence of MRONJ in patients who underwent denosumab and invasive dental treatment (especially tooth extraction) between October 2016 and March 2020. Four of the 98 patients developed MRONJ before and after tooth extraction. The participants were divided into two groups: receiving only denosumab (n = 51) and receiving bisphosphonate as first treatment and denosumab as second treatment (n = 47). There was no significant difference between groups in the occurrence of MRONJ and factors affecting MRONJ. Two out of 4 patients developed MRONJ regardless of invasive treatment after denosumab administration and proceeded with extraction; one patient developed MRONJ after denosumab administration and extraction. The other patient underwent a tooth extraction without osteoporosis treatment, and non-identified MRONJ developed after denosumab administration. MRONJ cases reported in this study show that MRONJ can develop as chronic inflammation without invasive dental treatment; therefore, implementing preventive dental treatment before initiating denosumab treatment is necessary to reduce the occurrence of MRONJ.

Clinical Characteristics of Patients Diagnosed With Odontogenic Rhinosinusitis After Dental Implants

Background and Objectives: With the ongoing development of intraoral surgical treatment and invasive dental treatments such as implants, odontogenic rhinosinusitis (ORS) is on the rise. ORS related to dental implants accounts for 8% to 37% of cases. The purpose of this study is to define the characteristics of patients with ORS related to dental implants.Methods: From 2015 to 2019, the medical records of 15 patients who developed maxillary sinus disease after receiving dental implants were retrospectively analyzed among patients who visited the ear nose and throat and dentistry departments. We reviewed the chief complaint, assessment, diagnosis, treatment and prognosis of these patients.Results: Of the 15 patients, all were diagnosed with ORS. One patient with a post-operative cheek cyst, 1 with fungal sinusitis, 1 with an inverted papilloma, 1 with chronic rhinosinusitis, and 1 with a radicular cyst were diagnosed after surgery. Endoscopic sinus surgery was performed in 14 patients and 2 patients underwent a combined operation. One patient improved after medical treatment. The follow-up period was about 8.6 months. No recurrence was found in any of the patients.Conclusion: If an implant problem is suspected based on history-taking and physical examination, active consultation with dentistry is needed to diagnose ORS.

Invasive dental treatment and acute vascular events: A systematic review and meta‐analysis

BackgroundAcute infection/inflammation increases the risk of acute vascular events (AVEs). Invasive dental treatments (IDTs) trigger short‐term acute inflammation.PurposeThe aim of this work is to critically appraise the evidence linking IDTs and AVEs.Data SourcesSix bibliographical databases were searched up to 31 August 2021. A systematic review following PRISMA guidelines was performed.Study SelectionIntervention and observational studies reporting any AVEs following IDT were included.Data ExtractionTwo reviewers independently extracted data and rated the quality of studies. Data were pooled using fixed‐effect, inverse variance weights analysis.Risk of BiasRisk of bias was assessed by the Newcastle–Ottawa Quality Assessment Scale for observational studies and the Cochrane Handbook–Rob 2.0 for randomized controlled trials.Data SynthesisIn 3 out of 16 clinical studies, a total of 533,175 participants, 124,344 myocardial infarctions, and 327,804 ischaemic strokes were reported. Meta‐analysis confirmed that IDT did not increase incidence ratios (IR) for combined vascular events either at 1‐4 weeks (IR of 1.02, 95% CIs: 0.92 to 1.13) and at 5‐8 weeks (IR of 1.04, 95% CIs: 0.97 to1.10) after treatment.LimitationsA high level of heterogeneity (study designs and time point assessments) was found.ConclusionPatients who received IDT exhibited no substantial increase in vascular risk over 8 weeks post treatment.

Osteonecrosis development by tooth extraction in zoledronate treated mice is inhibited by active vitamin D analogues, anti-inflammatory agents or antibiotics

Invasive dental treatment such as tooth extraction following treatment with strong anti-bone resorptive agents, including bisphosphonates and denosumab, reportedly promotes osteonecrosis of the jaw (ONJ) at the extraction site, but strategies to prevent ONJ remain unclear. Here we show that in mice, administration of either active vitamin D analogues, antibiotics or anti-inflammatory agents can prevent ONJ development induced by tooth extraction during treatment with the bisphosphonate zoledronate. Specifically, tooth extraction during treatment with zoledronate induced osteonecrosis in mice, but administration of either 1,25(OH)2D3 or ED71, both active vitamin D analogues, significantly antagonized osteonecrosis development, even under continuous zoledronate treatment. 1,25(OH)2D3 or ED71 administration also significantly inhibited osteocyte apoptosis induced by tooth extraction and bisphosphonate treatment. Administration of either active vitamin D analogue significantly inhibited elevation of serum inflammatory cytokine levels in mice in response to injection of lipopolysaccharide, an infection mimetic. Furthermore, administration of either anti-inflammatory or antibiotic reagents significantly blocked ONJ development following tooth extraction and zoledronate treatment. These findings suggest that administration of active vitamin D, anti-inflammatory agents or antibiotics could prevent ONJ development induced by tooth extraction in patients treated with zoledronate.

CURRENT CONCEPTS AND TECHNIQUES IN CARIES EXCAVATION: A REVIEW

Dental caries is one of the most prevalent chronic diseases in children and adults which often leads to poor quality of life. Majorly, children are afraid of their dental visits and avoid dental appointments due to invasive dental treatment procedures which directly inuence their dental health and leads to poor oral and general health. Over the years, to emphasize a biological and conservative approach, treatment modality from “drill and ll” to “minimal intervention” has been evolved. Minimal intervention techniques function to conserve the tooth structure, limit the pulpal exposure, increase the long-term prognosis and lastly, to increase the cooperation of patients and their parents as well. Change is the “only constant” in this evolving world, and thereby for ages, there has been the introduction of various non-invasive caries removal strategies to ease and condolence the patients and the operator as well. Now is the era where the fundamental key is to repair not to replace.